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Senator Irene Aguilar Targets Costs, Home Care, Physician Shortage

An Interview with Catherine Strode
Senator Irene Aguilar Targets Costs, Home Care, Physician Shortage
State Senator Irene Aguilar (District 32), Chair of the Senate Health and Human Services Committee, sponsored a bill in the 2014 session establishing a commission to study the drivers of health care costs (SB14-187). She also sponsored a bill affecting the delivery of in-home support services in the Medicaid program (HB14-1357.)
Health Care Advocacy Program Policy Perspective
Senator Irene Aguilar Targets Costs, Home Care, Physician Shortage
State Senator Irene Aguilar (District 32), Chair of the Senate Health and Human Services Committee, sponsored a bill in the 2014 session establishing a commission to study the drivers of health care costs (SB14-187). She also sponsored a bill affecting the delivery of in-home support services in the Medicaid program (HB14-1357.) One of her future aspirations is to introduce legislation to help eliminate physician shortages throughout the state.
In an interview with Catherine Strode, the Health Care Advocacy Program’s Consultant, Senator Aguilar discusses her support of community care under Medicaid waiver programs and potential legislation for a pilot licensure program for physicians educated out of the country. She has high hopes for the Colorado Commission on Affordable Health Care and its impact on state health care costs.
How can we control health care costs in the state?
“What I’m most looking forward to and have hope for is the Colorado Commission on Affordable Health Care. I think the biggest barrier to people purchasing insurance is the price, not only the price but their co-payments and deductibles. That’s all part of the price, the paying price of the product and what the product offers. Health care is such a huge industry; I think it’s up to forty billion dollars in Colorado alone. The problem is anytime you do something that controls costs, somebody loses their livelihood or has their way of doing business fundamentally changed. It really becomes hard because those folks are lobbying to not have it change. I’m hoping that by getting all the players who have their finger in the health care pie together at a table, they can come to some agreement over what actually adds value to health care and what adds costs. What they’re being asked to do is look at things where there is evidence that suggests can control costs of health care and then make recommendations about what we should do in Colorado because of that evidence.”
What is your vision of the ideal outcome of the commission?
“That it would have some great ideas every year leading to new legislation in our state or to new practices in the private sector and that it would be continued until health care was as affordable as they thought it could be. I had modeled it on the Colorado Commission on Criminal Juvenile Justice. That idea of getting the stakeholders together and saying, “We’re going to have to cut something, what are we going to cut?” Or, “What would you suggest is a way to do it that can preserve access, and quality, and patient satisfaction?” Getting access to care is a barrier for everyday people and that means that the corporations are winning and the people are not. I don’t think there should be any discussion on making cuts to Medicare until we have bulk negotiation on drug prices. I think that’s symbolic of what happens in many other areas of health care which is why the Cost Commission has the potential to do a lot if it can build public will as well.”
What does the bill, In Home Support Services in Medicaid Program HB14-1357, provide for?
“Like Consumer Directed Attendant Support Services (CDASS), it allows you to hire your spouse as your caregiver. The second thing it does is it says you can get your care in the community. It was brought to me by people who do long term home care. They had a number of clients who were having trouble identifying caregivers, particularly in rural areas. Their clients wanted to be able to pay their spouse to provide some of their care. It was a big barrier for a number of their people. I’d like to get the Department starting to think about not only getting people off a waiting list but allowing them to do Consumer Directed Services. Right now those are only allowed in certain waivers and a lot of the developmental disability community is not in those waivers. We’re sending the message that we really want consumers to have the ability to make their own choices and not have to go through a community centered board if they don’t think they need to.”
What health care legislation are you considering for the 2015 session?
“I had an incredible meeting with two doctors who have practiced in other countries for a long time who can’t get licenses in the US. If you’re educated out of the country, you have to do a year of training in the US; and the training programs won’t accept you unless you have just been in medical school. These providers are in a little bit of a ‘Catch 22.’ This group was proposing that we design some kind of mentorship program for doctors who are highly qualified but can’t get a residency here. I want to try and come up with some kind of pilot program where we can make this happen. We have a provider shortage and the program would be family practiced base.”

 

 

Catherine StrodeCatherine Strode is the Consultant to the Health Care Advocacy Program. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Formerly the Coordinator of the Program, Catherine publishes the HCAP newsletter featuring interviews with state legislators and represents the Program at meetings and events which pertain to policy matters.